Prior Authorization Specialist

Cap Talent HR; Hyderabad; On-site; INR 300,000 - 540,000; Full time

Benefits offered by this job

Night Shift Allowance

Fixed Week Offs

Two-Way Cab Facility

Self-Transportation Allowance

Career Growth Opportunities

Job summary

Cap Talent HR in Hyderabad, India is seeking an experienced Prior Authorization Specialist to obtain prior authorizations and referrals, verify patient insurance eligibility, and coordinate with payers for timely approvals of procedures, surgeries, injections and DME services.

The ideal candidate has 1.6 to 4 years of hands-on experience in prior authorization, strong knowledge of medical terminology, and familiarity with EMR/EHR systems and payer guidelines.

Qualifications

• Experience in Prior Authorization / Pre-Authorization is required.
• Strong knowledge of medical terminology and healthcare insurance processes.
• Experience with insurance portals and payer guidelines.
• Excellent communication and follow-up skills.
• Attention to detail and accurate documentation.
• Ability to work in a fast-paced healthcare environment.
• Familiarity with EMR/EHR systems is preferred.

Responsibilities

• Obtain prior authorizations and referrals from insurance companies.
• Verify patient insurance eligibility and coordinate with payers for approvals.

Skills

Prior Authorization

Pre-Authorization

Medical terminology

Healthcare insurance processes

Insurance portals

Payer guidelines

Communication skills

Follow-up skills

Attention to detail

Documentation accuracy

Fast-paced environment

EMR/EHR systems

Analytical skills

Problem-solving

Multi-tasking

Education

Graduate

Tools

EMR/EHR systems

Job description

Role & responsibilities

Job Summary: We are seeking experienced and detail-oriented Prior Authorization Specialists with a strong understanding of medical terminology and healthcare insurance processes. The ideal candidate will be responsible for obtaining prior authorizations and referrals from insurance companies,verifying patient insurance eligibility, and coordinating with payers to ensure timely approvals for procedures, surgeries, injections, and DME services.

Experience : 1.6yrs to 4 years

Preferred candidate profile

Required Skills & Qualifications:

• Minimum 1.6+ years of experience in Prior Authorization / Pre-Authorization.
• Strong knowledge of medical terminology and healthcare insurance processes.
• Experience working with insurance portals and payer guidelines.
• Excellent communication and follow-up skills.
• Strong attention to detail and documentation accuracy.
• Ability to work in a fast-paced healthcare environment.
• Familiarity with EMR/EHR systems is preferred.

Preferred Candidate Profile:

• Experience handling authorizations for surgeries, procedures, injections, and DME.
• Good analytical and problem-solving skills.
• Should be a Graduate.
• Ability to manage multiple tasks with minimal supervision.

Benefits

• Night Shift Allowance: 100 per working day
• Fixed Week Offs: Saturday & Sunday
• Two-Way Cab Facility (Within 25 KM Radius)
• Self-Transportation Allowance up to 3,500 per month
• Excellent Career Growth Opportunities